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Cocaine use in persons on methadone maintenance.

R Hanbury, V Sturiano, M Cohen

    Advances in Alcohol & Substance Abuse
    |January 1, 1986
    PubMed
    Summary

    Cocaine use among heroin addicts in methadone maintenance therapy decreased, with 17% stopping use. However, about half still used cocaine, often via injection, indicating continued challenges.

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    Area of Science:

    • Addiction Medicine
    • Public Health
    • Pharmacology

    Background:

    • Cocaine use has increased significantly across society.
    • Cocaine use among heroin addicts is a long-standing issue.
    • The impact of methadone maintenance therapy on cocaine use patterns is not well understood.

    Purpose of the Study:

    • To investigate changes in cocaine use prevalence and patterns among individuals in methadone maintenance therapy.
    • To compare cocaine use before and during methadone treatment.
    • To assess the effectiveness of methadone maintenance in reducing cocaine use.

    Main Methods:

    • A survey was conducted among patients undergoing methadone maintenance therapy.
    • Participants reported on their history of cocaine use before and during treatment.
    • Data on routes of administration and cessation of use were collected.

    Main Results:

    • Of 196 participants, 64 had no prior cocaine use, and 132 reported prior use.
    • Among those with no prior use, 14% used cocaine during treatment.
    • Of those with prior use, 31% stopped, and 69% continued.
    • Approximately 50% of all participants used cocaine at least once during methadone maintenance.
    • Parenteral administration was the predominant route for those using cocaine before and during treatment.
    • A net 17% of patients ceased cocaine use due to methadone maintenance.
    • Random urinalysis showed low positive rates (14-18%), underestimating prevalence.

    Conclusions:

    • Methadone maintenance therapy is associated with a decrease in cocaine use among heroin addicts.
    • Despite reductions, cocaine use remains considerable within this population.
    • The pattern of cocaine use in this group differs from recreational users.
    • Random urinalysis is an insensitive measure for assessing cocaine use prevalence in methadone maintenance patients.

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